Coronary Artery (Disease) Risk Development in (Young) Adults (CARDIA), is a longitudinal study of the distribution and evolution of risk factors for cardiovascular disease (CVD) in 5,115 18 to 30 year old black and white men and women with a range of attained education. CARDIA is designed to increase understanding of contributors to changes in CVD risk factors during the critical years of transition from adolescence through young adulthood to middle age. The primary objectives of CARDIA are: (1) to document at baseline and a approximately two to three year intervals, levels of risk factors for coronary artery disease and potential determinants of these risk factors in subjects 18 to 30 years old at the time of entry into the study; (2) to study the inter- relationships of risk factors and lifestyles and to document behavioral and environmental changes during the transition from adolescence to middle age; (3) to compare cross-sectional and longitudinal data on age- related trends in cardiovascular disease risk factors; and (4) to compare levels and evolution of risk factors between men and women blacks and whites, and in groups of differing socioeconomic status. Five examinations of the cohort have been conducted. Each examination has included the same core measurements, including blood pressure for tracking the development of hypertension, lipids, anthropometric measurements, smoking, physical activity and assessments of sociodemographic and other psychosocial characteristics. Fasting insulin/blood glucose levels were measured at baseline and at several later examinations to determine the association between insulin levels, diabetes, and cardiovascular disease. New measurements have been included at each examination, including echocardiography in Year 5 and 10; detailed quantitative dietary assessments and maximal, symptom- limited treadmill testing at baseline and year 7; 24 hour ambulatory blood pressure measurement; vascular distensibility; 72 hours urine collections for sodium, potassium, creatinine and magnesium; skin reflectance; selected psychological characteristics; vascular stiffness; and microalbuminuria. A pilot study of electron-beam computed tomography was conducted in Year 10 to assess coronary calcium.